咽喉之地，最为急症。顷刻而痛难忍者系寒，婉转而痛方胜者系热，犹之雷电之焰因阴
生，
燎原之火由渐着。《内经》云∶骤起非火，缓发非寒。虚寒实热，识透者获济。是在明达之
士，知所区别，乃随所施而无误耳。
马曰∶喉痛之症，色白，不红不肿者，寒也，红而肿者，火也。然色白者，亦有因风；
白而
微肿者，痰与气也。《内经》之骤起非火，缓起非寒，非指喉痛而言。若云初起，实系寒生
，未必尽然，或有伏热在内，如服肉桂，岂不助暴为虐？疑似之间，莫若先以姜汤试之，最
为稳当。
陶曰∶先生言或有伏热在内，如服肉桂，岂不助暴为虐是矣，但以姜汤试之。其法亦未
尽
善，盖姜亦热物也。如不识脉之人，何不用西医寒暑表，测其寒热。况予有医学简便寒暑表
，其法较泰西所作尤为灵捷。作表及用法，其说颇长，已载予着《有益斋杂记》内。
痹者，不仁也。本无毫恙，顷刻而起，此系虚寒阴火，最为危急之症。其见证痰在喉中
作响
，响如打鼾，舌色白而不肿，诸书皆称肺绝不救。盖缘误服寒凉，以致死耳。当以桂姜汤缓
缓咽下，可以立愈。或以生川附切片，涂以白蜜，火炙透黑，收贮，临用取如细粞一粒，口
含咽津，亦立刻痊愈。先以鹅毛粘以桐油，入喉卷之，痰出服药。
马曰∶痹者，闭塞之谓，非不仁之谓。痹症汤饮犹可通，若闭则水浆不能入矣。用卧龙
丹吹之，取嚏可松。
陶曰∶又∶皂角末或半夏末，吹入鼻中，皆可取嚏。如无药物，即以细纸捻子在鼻中搅
之，亦可取嚏。凡咽喉初觉壅塞，即用此法，取嚏数次，亦可散热毒，此通窍法也。
咽喉部位发生的疾病，属于最为急重的病症。如果疼痛突然发作且难以忍受，这属于寒证；如果疼痛逐渐加剧后才变得剧烈，这属于热证，这就好比雷电般的火焰是因阴气而生，燎原的大火是逐渐燃烧起来的。《黄帝内经》说：突然发作的不是火证，缓慢发发的不是寒证。能够辨别虚寒和实热的医生，就能获得救治患者的机会。这需要明理通达的人士，清楚地加以区别，从而在施治时不出差错。
马元仪说：喉痛的症状中，颜色发白、不红不肿的，是寒证；发红且肿胀的，是火证。然而颜色发白的，也有因风邪引起的；发白且轻微肿胀的，是痰湿和气滞所致。《黄帝内经》所说的“骤起非火，缓发非寒”，并不是专指喉痛而言。如果说初起确实是寒邪引起，未必完全正确，因为体内可能有伏热，如果此时服用肉桂，岂不是助长邪气更加肆虐？在疑似难辨之间，不如先用姜汤试探，最为稳妥。
陶华说：先生所说体内或有伏热，如果服用肉桂，岂不是助长邪气更加肆虐，这是对的。但是用姜汤来试探，这种方法也不尽完善，因为生姜也是热性药物。如果不识脉象的人，为什么不使用西医的寒暑表（体温计），来测量其寒热情况呢？况且我有简便易行的医学寒暑表，其方法比西方制造的更为灵敏快捷。制作表格及使用方法，说法颇长，已经记载在我所著的《有益斋杂记》一书中。
痹，是指麻木不仁。患者原本没有病痛，却突然发作，这属于虚寒阴火，是最为危急的病症。其表现为喉中有痰鸣响，声音像打鼾一样，舌色发白且不肿胀，各种医书都称之为肺绝，认为无法救治。这其实是误服寒凉药物导致死亡的结果。应当用桂姜汤慢慢咽下，可以立即痊愈。或者取生川附子切片，涂上白蜜，用火烤至透黑，收藏起来，使用时取如细米粒大小的一粒，含在口中吞咽津液，也能立刻痊愈。先用鹅毛蘸上桐油，伸入喉中卷动取出痰液，然后再服药。
马元仪说：痹，是指闭塞的意思，而不是指麻木不仁。痹症通过汤药饮食还可以疏通，如果是闭症，则连水浆都无法入口了。可以用卧龙丹吹入鼻腔，引发喷嚏可以使症状缓解。
陶华说：另外，将皂角末或半夏末吹入鼻中，都可以引发喷嚏。如果没有药物，就用细纸捻子在鼻中搅动，也可以引发喷嚏。凡是咽喉刚开始觉得壅塞不通，就立即使用这种方法，引发几次喷嚏，也可以散发热毒，这就是通窍的方法。
The throat region is the site of the most acute and critical conditions. Sudden onset with unbearable pain indicates Cold (Han, cold syndrome); gradual progression to severe pain indicates Heat (Re, heat syndrome). This is akin to lightning flames arising from Yin, or prairie fires igniting gradually. The *Huangdi Neijing* states: "Sudden onset is not Fire; slow onset is not Cold." Those who clearly distinguish between Deficient Cold and Excess Heat can save patients. It is up to enlightened practitioners to differentiate these accurately, thereby ensuring correct treatment without error.
Ma Yuanyi stated: In cases of sore throat, a white color without redness or swelling indicates Cold; redness and swelling indicate Fire. However, a white color may also result from Wind pathogen; white with slight swelling indicates Phlegm and Qi stagnation. The *Neijing*'s statement "sudden onset is not Fire, slow onset is not Cold" does not refer exclusively to sore throats. To claim that initial onset is truly due to Cold is not necessarily always true, as there may be latent Heat within. If Cinnamon Twig (Rougui) were administered in such cases, would it not exacerbate the condition? Amidst such ambiguity, testing with Ginger Decoction first is the safest approach.
Tao Hua stated: While agreeing with the Master's point that latent Heat within could be worsened by Cinnamon Twig, using Ginger Decoction for testing is not entirely sound, as Ginger is also a hot-natured substance. For those unfamiliar with pulse diagnosis, why not use a Western thermometer to measure temperature? Furthermore, I possess a simple medical thermometer, which is more agile and accurate than those manufactured in the West. The details of its construction and usage are lengthy and have been recorded in my work *Youyi Zhai Zaji*.
Bi (Obstruction/Numbness) refers to numbness. A patient who was previously healthy but suddenly develops this condition suffers from Deficient Cold and Yin Fire, a critically dangerous syndrome. Manifestations include rattling phlegm in the throat, sounding like snoring, with a white, non-swollen tongue. Various texts label this as Lung Exhaustion (Fei Jue), deeming it incurable. This death results from the mistaken administration of Cold-Cooling herbs. One should slowly swallow Cinnamon-Ginger Decoction for immediate recovery. Alternatively, take slices of Raw Chuanwu (Aconiti Lateralis Radix Preparata), coat them with white honey, roast over fire until thoroughly blackened, and store. Upon use, take a grain-sized piece, hold in the mouth, and swallow saliva; recovery is immediate. First, use a goose feather dipped in tung oil to induce vomiting and remove phlegm from the throat, then administer medicine.
Ma Yuanyi stated: Bi refers to obstruction, not numbness. In Bi syndromes, soups and drinks can still pass through; in Bi (closure) syndromes, even water cannot enter. Blowing Wolong Dan into the nose to induce sneezing can relieve the blockage.
Tao Hua stated: Additionally, blowing powder of Sichuan Pepper Fruit (Zaojiao) or Pinellia Rhizome (Banxia) into the nose can induce sneezing. If no medication is available, twisting a fine paper wick in the nose can also induce sneezing. Whenever one initially feels congestion in the throat, employing this method to induce several sneezes can dissipate heat and toxins. This is a method for opening the orifices.